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Benefits of exclusive breastfeeding on children's later development in rural South Africa

Exclusive breastfeeding has been shown to be very important for the children of mothers who are HIV positive in low/middle income countries. No studies had previously looked at the longer term effects of such exclusive breastfeeding. We showed that there were important benefits, principally in relation to children’s behaviour. This study reinforced the longer term importance of exclusive breastfeeding in low/middle income countries, especially in the context of HIV.- Professor Alan Stein

In this study, published in PLOS Medicine, an international team led by a team of investigators, including Professor Alan Stein of the Department of Psychiatry, University of Oxford, assessed over 1,500 children in rural South Africa, 900 of whom had been involved in an early infant feeding study.

They found longer durations of exclusive breastfeeding was associated with fewer behaviour problems at ages 7 to 11 years. Children exclusively breastfed for the recommended six months, compared with those exclusively breastfed for less than one month, were approximately half (56 percent) as likely to have behavioural problems at primary school age.

The study also examined a number of current life factors that might influence children’s development, finding that children were two-and-a-half times more likely to exhibit emotional-behavioural problems if their mothers had a current mental health problem or severe parenting stress.

Other highlighted findings included:

Important determinants of a child’s cognitive development: attending crèche (preschool) and mother’s IQ.

Children who attended crèche for at least one year were 74 percent more likely to have higher executive function. (This enables us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. The brain needs this skill set to filter distractions, prioritize tasks, set and achieve goals, and control impulses. Executive function, therefore, influences educational and social success.)

Children stimulated at home, such as through play, were one third (36 percent) more likely to have higher executive function scores.

There was weaker evidence that, for boys, exclusive breastfeeding for more than one month improved cognitive development.